My Name is Paul H Cosentino. I started this Blog in 2011 because of what I believe to be wrongdoings in town government. This Blog is to keep the citizens of Templeton informed. It is also for the citizens of Templeton to post their comments and concerns.

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Sunday, March 26, 2017

Lyme disease preventable by taking steps to avoid tick bites

Lyme disease preventable by taking steps to avoid tick bites

Lisa M Faust is seen with her Lyme medicines at home in Charlton [T & G Staff/Christine Peterson]

Pest control experts who began seeing ticks in early February because
of a warm winter and an abundance of acorns now say this will be one of
the worst tick seasons in years - which may lead to an increase in Lyme
disease.

While that may be true, health experts point out that in Massachusetts and other parts of the Northeast, where Lyme disease
is endemic, every year is a bad tick season. Their advice is to not
focus on how many ticks there might be this year, but instead, become
educated on how to prevent tick bites.

Dr. Catherine M. Brown, deputy state epidemiologist and state public
health veterinarian with the state Department of Public Health, said
she's not sure if the prediction is helpful because there are always
thousands of cases of Lyme every year.

"We're considered endemic
for Lyme, which means we have it all over the Commonwealth, and we have
it all the time," she said. "I want people to be aware and to take steps
to prevent tick bites, not just in the year when people say it might be
bad."

Chris G. Ford, president of Ford's Hometown Services on
Grove Street in Worcester, said he and other pest control folks learned
of the hearty rodent population at the Central Massachusetts Pest
Control Association's seminar in Sturbridge last month.

Some small
animals, particularly the white-footed mouse, carry the bacteria that
causes Lyme. When a tick, usually in the nymph stage, attaches to the
carrier for a blood meal, it becomes infected and passes the infection
on to humans and other animals.

Mr. Ford said the number of phone
calls from people signing up for the company's four-application tick
protection program spiked during the warm spell in February when people
began seeing ticks. April through September is when the greatest risk of
being bitten exists. But, adult ticks are out in search of a host in
winter when temperatures climb above freezing.

"We've had multiple
calls coming in already regarding people's pets and children getting
ticks on them," he said. Mr. Ford, who is also president of
Massachusetts Association of Lawn Care Professionals, said mosquito and
tick control has grown to be the largest segment of the 75-year-old
family company.

Massachusetts ranked fourth in the nation (behind Pennsylvania, New
Jersey and New York) in the incidence of Lyme cases reported to the
Centers for Disease Control and Prevention in 2015, the last year for
which the data is available. Ninety-five percent of the confirmed cases
of were reported in 14 states - including all of New England - where the
black-legged tick is found. There were 2,922 confirmed cases and 1,302
probable cases in Massachusetts in 2015.

But, as the CDC first
announced at an international conference in Boston in 2013, Dr. Brown
said the actual number of cases each year is likely 10-fold what is
reported.

The 4,000 to 6,000 confirmed and probable cases of Lyme
reported each year in Massachusetts are the only ones where there is
enough information to assign them based on the current surveillance
system, Dr. Brown said. As a result of the limitations, the department
is developing a new system of counting Lyme cases which should be
available before the end of the year.

"There are 14,000 to 16,000
positive lab results, and yet we don't often have enough clinical
information to count these people based on the (current system)," she
explained.

Other states are also using different methods, which
makes it impossible to compare states. Dr. Brown said some counties in
New York had so many Lyme cases that they are following up on and
reporting only a sampling of cases. According to the CDC, New York had a
total of 4,314 confirmed and probable cases of Lyme in 2015.

"All
of this speaks to why we're looking at the old way and thinking it is
not really accurate and appropriate," she said. "We're looking at trying
to use other data sources and evaluate the data we have more creatively
to provide a better assessment of the true risk and burden that Lyme
disease places on Massachusetts residents, as well as the health care
system."

More Lyme disease than mosquito-borne diseases

Lyme disease is the most prevalent vector-borne disease in the
country. It affects many more people than Eastern equine encephalitis
and West Nile virus combined. Dr. Brown, with the DPH, said the state,
like some in other parts of the country, has considered a program to
spray for ticks, similar to the current mosquito control program. She
said one of the reasons that has not been established is because of a
CDC study involving four other high Lyme incidence states that didn't
show to fix the problem. The study looked at pairs of neighborhoods: one
sprayed yards with insecticide; the other sprayed water. She said the
properties that used insecticide did end up having fewer ticks. But the
number of Lyme cases were the same for both pairs of neighborhoods.

"People
don't get exposed to infected ticks only in their yard," Dr. Brown
said. "The other factor that could be involved is, if you know your yard
has been sprayed for ticks, maybe you are not as concerned about using
repellent and doing tick checks."

Lyme disease is difficult to
diagnose. If not treated early, it can spread to many organs and systems
in the body, including the central nervous system, cardiovascular
system, the eyes, the liver and muscles, and joints.

Treatment is
controversial. There are two schools of thought. The Infectious Disease
Society of America has expressed concern about over-treatment of
antibiotics and recommends limited treatment options, usually up to four
weeks. The International Lyme and Associated Disease Society recommends
treatment determined by clinical judgment. In some cases, that means
long-term treatment with antibiotics.

Most health insurance
companies only paid for the limited treatment until last year, after a
years-long battle by Lyme victims and other advocates led to the
Legislature enacting a law requiring private health insurers to cover the cost of long-term treatment for the disease.

Trish McCleary, a longtime Lyme victim and co-founder of Sturbridge
Lyme Awareness of Massachusetts and the Massachusetts Lyme Coalition,
who helped get the law passed, estimates that she had paid more than
$100,000 for treatment of the disease. But, the law is not perfect, she
said. The law does not cover hundreds of thousands of people on
MassHealth, as well as state and some municipal employees, their
families and retirees who are covered by insurance administered by the
Group Insurance Commission.

State Rep. David P. Linsky, D-Natick,
sponsor of the legislation, said not including those people was not his
first choice, but a compromise to get the bill passed. He said it was a
budgetary decision because taxpayers pay 50 percent of MassHealth costs
and all the cost for government workers' insurance administered by the
Group Insurance Commission.

"It's fair to say that healthcare insurance throughout the country is
in a gigantic state of influx right now," Rep. Linsky said. "As much as
I would like to see expanded coverage for Lyme, anything Massachusetts
does has to be in accordance with federal law and we simply don't know
right now."
Lisa M. Faust, 53, of Charlton, said the law is having a "life-saving" effect for her.

Prior
to passage of the law, she was paying more than $3,000 a month out of
pocket for Bicillin, an intramuscular injectable antibiotic, she needs
to fight Lyme disease that she likely contracted in 2013.
After
the law passed, Mrs. Faust said she had to "fight tooth and nail" for
several weeks, and get state Sen. Anne Gobi involved, before Harvard
Pilgrim complied with the new law. She now only pays a monthly co-pay of
$250. The lower cost allows her to take the medication once a day as
prescribed, as opposed to every other day.

"Being able to stay on
this medication has changed my life in a very dramatically positive way.
I haven't had a fever in months. I have more energy," she said. "I
really feel I'll be off (the antibiotic) by summer. I'm so happy that
law passed. It's really life changing."

Prevention is the best medicine

Many
health experts throughout the country stress that the most important
tool available to prevent getting the devastating disease is to take
proven steps to prevent tick bites.

Dr. Sam R. Telford, III, an expert on tick-borne diseases and a
professor in the department of infectious diseases and global health at
the Cummings School of Veterinary Medicine at Tufts University in North
Grafton, said measures to significantly reduce the number of deer will
also greatly reduce Lyme cases. Deer is the primary host for the adult
tick to feed, and lay thousands of eggs. He also pointed out that
tremendous strides were made in reducing exposure to Lyme a few years
ago, because of a CDC grant that paid the salary of a person to educate
residents on Cape Cod about reducing their risk to Lyme and other
tick-borne infections. The work stopped when the grant ran out, he said.

"Education is really the only way we're going to get a handle on this," he said. "We can wait and wait for a vaccine."

There
is a vaccine for dogs, but there is no longer one for humans. The only
human vaccine against Lyme disease, called LYMERix, was licensed in
1998, and taken off the market in 2002 because there was not enough
demand for it, and some reported side effects.

Scientists
affiliated with University of Massachusetts Medical School are currently
developing a medicine that could prevent people from getting the
disease.

Dr. Mark S. Klemper, professor of medicine at UMass
Medical School and executive vice chancellor of the school's
MassBiologics, where Lyme pre-exposure prophylaxis or Lyme PrEP was
developed, said excellent progress has been made.

He said that
unlike a vaccine which causes the body's immune system to make a lot of
antibodies, this medicine is a single human antibody that prevents
infection from tick bites. Once the scientists have confirmed that the
antibody provides protection for at least six months, clinical trials in
people will begin.

Dr. Nancy A. Shadick, a rheumatologist at
Brigham and Women's Hospital, is convinced that education is key in
reducing the state's Lyme epidemic. She conducted a study called A
School-Based Intervention to Increase Lyme Disease Preventive Measures
Among Elementary School-Aged Children, that involved 3,570 students in
nine school districts in Essex County, on the North Shore, which is
highly endemic for Lyme disease. There is a higher incidence of the
disease in children ages 5 to 9, because they are less likely to find
the tick and have it removed in time to prevent transmission. According
to the CDC, the tick must be attached for 36 to 48 hours or more before the Lyme disease bacterium can be transmitted.The
study taught about half of the children about the disease and
preventive behaviors that decrease their chances of getting sick. The
remaining elementary school students in the study did not get that
education.

Dr. Shadick, in an email Thursday, said she would recommend that a
similar program be expanded to all public elementary schools in the
state.

"The children increased their knowledge of Lyme disease and
reported that they took more tick bite precautions," she said. "They
had an improved attitude toward taking precautions and had more
self-confidence that they could find a tick on themselves compared with
the control group of children who did not get the in-school curriculum."

The
Massachusetts Health Officers Association (MHOA) is working to develop a
toolkit for municipal health departments to use to educate communities
about Lyme and precautions for people to take. Sam Wong, public health
director in Hudson who is MHOA's vice president, said while Lyme is the
most prevalent tick-borne disease in Massachusetts, there are others,
including Babesiosis and Powassan virus, that we are beginning to see.

"We're
seeing the number of cases trending up over the years. With the climate
change, we expect to see those numbers going even higher," he said.
"Local health departments and the state health department can do a lot
on educating the public on these issues."

Autohemotherapy is a process whereby they take your blood, between 6-12 oz. ; inject the drawn blood with ozone and then use an IV to reintroduce the blood/ozone mix. It takes a little over an hour. It is used for Lyme and other diseases